Put a Doctor in Your Pack
Looking inside first aid kits
Several studies have been published in recent years, which examine and better define the first aid needs and health issues of backcountry travelers. One study, a field survey accessing the risk of injury and illness of backcountry hikers in Yosemite National Park and published in the Journal of Wilderness Medicine found that 15% of backpackers had to shorten their intended trip at one time or another because of a medical reason. Of those surveyed, the most common problems related were: insect bites, wounds, blisters and sunburn. Acute Mountain Sickness, asthma, allergic reactions, and lacerations were the most common of the serious medical problems. It was also found that on average, backcountry travelers carry only 48% of the recommended first aid supplies.
Todd Schimelpfenig, Safety and Training Director for the National Outdoor Leadership School (NOLS) recently published the results of a 5-year study of the types and severity of injuries and illnesses encountered during NOLS-led wilderness programs. He found that 56% of their medical incidents were a result of injury involving sprains, strains, and wounds to soft tissue. Fractures and dislocations accounted for 4.6% of all injuries. Non-viral syndromes or diarrhea accounted for 60% of medical problems related to illness. Eighteen cases involved dental problems. Forty-three percent of all the problems required evacuation.
What does all this mean? Manufacturers are looking at data such as this to help them design their kits to more effectively meet your anticipated backcountry needs and you can use this information to better evaluate your purchases and the way in which you put together a backcountry first aid kit. An excellent way of staying current and receiving the best up-to-date first-aid information is by joining the Wilderness Medical Society in Indianapolis, Indiana as an Associate Member. Anyone may join by calling (317) 631-1745. While the Journal of Wilderness Medicine may be too technical for most folks, the newsletter is worth the price of admission alone.
Dr. Howard Donner and Dr. Eric Weiss, both active members of the Wilderness Medical Society and highly respected medical doctors with vast emergency room and backcountry emergency experience were asked to comment on a number of contents found in first aid kits to help clarify what should and should not find its way into a good kit. This is what they had to say on:
Gloves
Yes, vinyl gloves are cheaper, but they leak more readily making them less valuable as a protective device for the user. For that reason, the recommended gloves are Latex.Splints
SAM splints are the way to go for orthopedic injuries of all kinds since it can be cut and molded to fit any extremity, can be fashioned into a usable cervical collar, is reusable, isn't affected by temperature extremes, and is x-ray permeable. Toss the wire splints.Re-hydration
Salt tablet were the standard for oral re-hydration needs, but what a lousy standard. Salt tablets are virtually impossible to digest and frequently induce vomiting--not what you want when it is re-hydration you are trying to achieve. World Health Organization oral re-hydration salt packets for treating diarrhea and dehydration are the standard in most good kits.Wound Management
Since the old days of traditional 4x4 gauze pads, wound dressings have gotten more sophisticated and feature non-adherent designs and hydrogel dressings such as Spenco 2nd skin. Cleansing a wound is now best performed via high-pressure irrigation utilizing an irrigation syringe. Gone too are the butterfly bandages, replaced by more effective wound closure strips. To eliminate sticking problems, be sure that your kit has tincture of benzoin in it which, when spread on the skin on either side of a wound, serves to help tape and bandages adhere better--useful when the skin is sweaty and dirty.Blisters
Feet should receive attention the minute friction or irritation is noticed. Always leave blisters intact unless infection is suspected. Spenco 2nd Skin and an adhesive pad is very effective in the prevention and treatment of blisters.Snake Bite Kits
Ice, electric shock treatment, constriction and those tiny kits with razor-sharp blades and miniature rubber suction cups are not safe, according to wilderness medical experts, and can do much more harm that good when treating for a snake bite. The Sawyer Extractor is the only snake bite kit that is actually acknowledged as useful in certain situations. The recommended first aid? Get the victim to a hospital where antivenin may be given safely.Medications
Tylenol will reduce fever and does relieve pain, but it does nothing for decreasing inflammation that can occur from a sprain or strain. Ibuprofen (Nuprin, Motrin, Advil) is the preferred choice for inflammation reduction. Benadryl is often included in today's kits as a treatment for mild allergic reactions, but medical doctors assert that if you are a frequent traveler in the backcountry you would be wise to add epinephrine in the form of an Epi Pen to treat more serious allergic reactions that might otherwise be fatal.
Which kits are best? It is good to remember that a first aid kit of any size or quality is only as good as the person using it. When I taught wilderness first aid, I used to tell my students that the best thing they could put in their kit was a brain filled to the brim with common sense. That said, I would highly recommend purchasing a commercially packaged kit from either of the following four companies, which come as close as any to putting a doctor in your pack: Atwater Carey (800/359-1646), Adventure Medical Kits (800/324-3517), Outdoor Research (800/421-2421) Tim Shannon or Randy King, and Sawyer (800/356-7811). Other commercially packaged kits cannot hold a candle to any of these four.
If you are having trouble finding any of the above kits in your local stores, or wish to obtain specialty first aid gear to refill your kit, then look no further than Chinook Medical Gear - the best, one-stop, mail-order shopping source I have found. Chinook Medical Gear, Inc. Call toll free in the U.S. and Canada, 1-800-766-1365 or international, 1-970-926-9277.
— Michael HodgsonPhotos courtesy of Adventure Medical Kits
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